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Endemic fluorosis in Turkish patients: relationship with knee osteoarthritis.

Abstract. Fluoride excess primarily effects dental and skeletal tissues, leading to a condition known as endemic fluorosis. The radiological and clinical features of endemic fluorosis vary in different parts of the world. The aim of this study was to investigate the clinical and radiological features of endemic fluorosis in Turkish patients. Physical examination and radiological investigations were performed in 56 patients with endemic fluorosis and 40 age- and sex-matched controls. Knee osteoarthritis (OA) was the main abnormality in both groups, both clinically and radiologically. The radiological severity of knee OA was greater in the endemic fluorosis group than in controls (P=0.01). Osteophytes at the tibial condyles and superior margin of the patellar articular surface of the femur, polyp-like osteophytes on the non-weight-bearing medial side of the femoral condyle, and popliteal loose bodies were detected more frequently in the endemic fluorosis group than in controls (P=0.0001). We suggest that the presence of atypically located osteophytes in the knees may be a feature of endemic fluorosis in Turkish patients and that endemic fluorosis may increase the severity of OA in the knees.

Pneumatized inferior turbinate

The inferior turbinate is a separate bone that extends from the body of the maxilla to the ethmoidal crest. Its arched central portion overhangs the so-called inferior meatus, which contains the opening of the nasolacrimal duct. The inferior turbinate is part of the nasal valve area, which is the narrowest part of the nose. During inspiration, airflow is directed upward and backward, mainly over the anterior part of the inferior turbinate.l Concha bullosa, pneumatization of the middle turbinate, is a well-recognized entity. It is the most common anatomic variation of the middle turbinate leading to various clinical problems.2 It may be either unilateral or bilateral, with different sizes, and may compromise the anatomy and function of the ostiomeatal complex. Pneumatization of the superior turbinate, which is also called concha bullosa of the superior turbinate by Stammberger,3 is a very rare entity, and only a few cases have been reported. 3,4 Pneumatization of the inferior turbinate has not yet been reported in the world literature. In this article, a patient with inferior turbinate pneumatization is presented.

Ionic High-Osmolar Contrast Medium Causes Oxidant Stress in Kidney Tissue: Partial Protective Role of Ascorbic Acid

It has been known that contrast medium may cause contrast-induced nephropathy in risk groups. This study sought to establish possible effects of ionic high-osmolar contrast medium administration with or without antecedent cisplatin treatment on oxidant/antioxidant status in rat kidney tissues, as well as to investigate a possible protective role of antioxidant ascorbic acid in this regard. Thirty-five female, 14-week-old Wistar-albino rats were used in this study. They were divided into five groups of seven rats (sham, contrast, contrast + ascorbic acid, contrast + cisplatin, and contrast + cisplatin + ascorbic acid). Ascorbic acid was given in a dose of 250 mg/kg/day orally throughout the study period, and cisplatin (10 mg/kg) as a single i.v. dose on the fourth day. Ionic high-osmolar contrast medium (3 gr/kg iodine as a single dose) was administered by i.v. route on the fifth day. After the animals were sacrificed on the sixth day, their kidney tissues were removed surgically to be used in the analyses. Malondialdehyde (MDA) level and activities of antioxidant (superoxide dismutase [SOD], glutathione peroxidase [GSH-Px] and catalase [CAT]) and oxidant (xanthine oxidase [XO]) enzymes were measured in these samples. Serum urea and creatinine levels were measured to evaluate kidney functions. Histopathological investigation of the tissues was also performed. It was observed that contrast medium administration caused increases in MDA levels in the kidney tissues, either alone or together with antecedent cisplatin treatment. However, ascorbic acid prevented the increases in MDA levels in the kidney tissues. Histopathological findings revealed that ionic high-osmolar contrast medium administration alone led to mild acute structural damage, but contrast medium administration together with antecedent cisplatin usage caused severe tubular necrosis. Ascorbic acid supplementation prevented these changes, to a great extent. The results suggest that ionic high-osmolar contrast medium administration, either alone or together with antecedent cisplatin treatment, leads to accelerated oxidative reactions in rat kidney tissues, and ascorbic acid protects in part the kidney tissues against this oxidant stress.

Stromal predominant type mesenchymal hamartoma of liver: CT and MR features

Mesenchymal hamartoma is a rare pediatric liver tumor. The tumor is mainly cystic but occasionally a solid component is seen. Therefore the tumor can be divided into two forms: (a) cystic predominant, and (b) stromal predominant. In this report, CT and MR features of stromal predominant type mesenchymal hamartoma are presented.

Ultrasound guided percutaneous treatment and follow-up of Baker's cyst in knee osteoarthritis

OBJECTIVE Purpose of this study is to assess sonographic changes and clinical response in different subgroups of Bakers cyst patients with knee osteoarthritis after a single session of ultrasound-guided percutaneous aspiration and corticosteroid injection. MATERIALS AND METHODS Thirty-two knee osteoarthritis patients (46-85 years, mean 58.97±9.88) with symptomatic Bakers cyst diagnosed at ultrasonography were included in the study. To determine the grade of the symptoms, Visual Analogue Scale was applied. The patients were grouped in two, as simple (n=24) and complex (n=8) Bakers cyst. Thirty-two ultrasound-guided cyst aspirations concomitant 1 ml betamethasone injection (24 simple, 8 complex subgroups) were performed. Patients were followed clinically as well as via ultrasonography for 6 months after procedures. RESULTS A significant decrease in volume of the Bakers cysts after percutaneous treatment was accompanied by a significant clinical improvement. Moreover, the volume reduction of Bakers cyst after the treatment was significantly correlated with the clinical improvement (Pearson correlation coefficient=0.542, p=0.001). All 6 Bakers cysts relapsed at ultrasonography were complex type. Furthermore, a comparison of patients with simple Bakers cysts and those with complex Bakers cysts demonstrated no significant change in Visual Analogue Scale scores between two groups (p=0.061, Mann-Whitney U). No complications (minor or major) occurred secondary to percutaneous treatment. CONCLUSION Bakers cysts can be grouped as simple and complex groups via ultrasonography prior to the treatment. Cyst aspiration with ultrasound-guided corticosteroid injection yields clinical improvement and cyst volume reduction in all subgroups of patients with Bakers cyst secondary to knee osteoarthritis.

Pre-operative Arterial Embolization of Symptomatic Giant Hemangioma of the Liver

The cavernous hemangiomas of the liver are usually small sized and asymptomatic. Most of them are incidentally diagnosed and a very small portion requires therapy. Giant hemangioma can be symptomatic, and this condition is the indication for treatment. The striking complication of surgical treatment of cavernous hemangiomas is intra-operative bleeding. In this case, we aimed to demonstrate that the risk of intraoperative bleeding can be eliminated with the preoperative percutaneous trans-catheter arterial embolization technique.

Endovenous laser ablation and foam sclerotherapy for varicose veins: does the presence of perforating vein insufficiency affect the treatment outcome?

Background Superficial venous insufficiency is a common problem associated with varicose veins. Endovenous laser ablation (EVLA) and concomitant ultrasound (US)-guided foam sclerotherapy are recent treatment methods alternative to surgery in the treatment of superficial venous insufficiency. Purpose To compare the effectiveness of EVLA and concomitant US-guided foam sclerotherapy prospectively in two different subgroups of the disease (isolated truncal vs. truncal with perforating vein insufficiency). Material and Methods The study was approved by the institutional review board. Fifty-five patients with symptomatic saphenous vein insufficiency and varicose veins were included in the study. Seventy-three EVLA and concomitant foam sclerotherapy were performed for 60 lower extremities. To determine the severity of the venous disease, Venous Clinical Severity Score (VCSS) and Visual Analogue Scale (VAS) were carried out before and 6 months after the treatment. Patients were followed up clinically and with Doppler ultrasonography for 6 months after the procedures. Results At the sixth month of the follow-up; the total occlusion rate for the saphenous veins was 98.64% (72/73), and re-canalization rate was 1.36% (1/73). The total occlusion rate for the perforating veins was 75% (18/24), re-canalization rate was 25% (6/24). There was no notable major complication. VCSS and VAS scores were decreased significantly following the treatment (p < 0.05). The patients who had isolated saphenous vein insufficiency (Group I: 36/60) and those who had saphenous and perforating vein reflux (Group II: 24/60) were compared. VAS scores were more prominently decreased after the treatment in the isolated saphenous vein insufficiency group (p < 0.05). VCSS were also decreased more prominently in Group I when compared to Group II. Conclusion EVLA and concomitant US-guided foam sclerotherapy are effective, safe, and minimally invasive treatment options, yielding good cosmetic and clinical results in both isolated truncal and truncal with perforating vein insufficiency groups. However, clinical results and satisfaction of the patients were remarkably superior in cases with isolated truncal vein insufficiency compared to truncal and perforating vein insufficiency.

Diagnostic quality of CT pulmonary angiography in pulmonary thromboembolism: a comparison of three different kV values.

Background Our purpose was to evaluate the effectiveness of different kilovolt (kV) uses in computed tomography pulmonary angiography (CTPA) in the diagnosis of pulmonary thromboembolism (PTE). We also aimed to establish the optimal kV value and investigate the possibility of obtaining appropriate imaging quality with minimal radiation dose. Material/Methods We compared 120, 100, and 80 kV CTPA for 90 patients in whom PTE was clinically considered. The examinations were carried out using a 128 multislice CT device (Definition AS, Siemens Medical Solutions, Forchheim, Germany). Each kV value was used on 30 patients in 3 groups. Patients in all groups were compared with respect to the mean radiation dose they received, pulmonary arterial attenuation values, image quality, and motion artefacts. Results With respect to pulmonary arterial attenuation values, imaging with 80 kV yielded significantly higher values (p<0.05). However, no difference was found between 120 kV, 100 kV, and 80 kV with respect to image quality. Similarly, no significant difference was detected between the groups with respect to pulmonary artery contrasting and motion artefacts. Statistically significant differences were present in DLP values and effective dose among all 3 groups (p<0.001). Conclusions Using 80 kV as the low value in CTPA imaging for patients pre-diagnosed with PTE will increase the density of pulmonary arteries and decrease the amount of radiation received.

Omental torsion with left-sided inguinal hernia: a rare preoperative diagnosis

Omental torsion is a rare disease. It can be difficult to identify if it is not clinically considered in the preoperative period, and this pathology may lead to an acute abdomen. We present the characteristic computed tomography findings and clinical particulars in a 34-year-old male patient with longstanding left inguinal hernia associated with an extraordinary diagnosis.

A New Turbinoplasty Technique for the Management of Concha Bullosa: Our Short-Term Outcomes†

INTRODUCTION Anatomical and physiological disorders of the ostiomeatal complex region may predispose individuals to chronic sinusitis. Pneumatization of the middle turbinate, the concha bullosa (CB), is one of the most common obstructive anatomic variations in patients with chronic sinusitis. The prevalence of CB has been reported to be between 8% and 53%. CB may require surgical intervention consisting of total or partial turbinectomy most commonly. Har-El and Slavit described a turbinoplasty procedure to minimize the risk of synechia during the postoperative period. We modified the technique of Har-El and Slavit to bring the two lamellas of the bullous concha closer to minimize the risk of synechia and mucocele formation. The short-term outcomes of turbinoplasty and partial turbinectomy were compared in this study.